Provider Demographics
NPI:1699883223
Name:LE, MEN THI HONG (DMD)
Entity type:Individual
Prefix:DR
First Name:MEN
Middle Name:THI HONG
Last Name:LE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1857 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-5345
Mailing Address - Country:US
Mailing Address - Phone:951-781-3021
Mailing Address - Fax:951-781-2900
Practice Address - Street 1:1857 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-5345
Practice Address - Country:US
Practice Address - Phone:951-781-3021
Practice Address - Fax:951-781-2900
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC423511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice